1980, 11-07 Permit: 80B-3412 AdditionNUMBER _W__ APPLICATION/PERMIT
� 11/7`ee SPOKANE COUNTY —BUILDING CODES DEPARTMENT
JNORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
5. y9i ! Ww (2-rLEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCKjSUBDIVlblOPARCEL NUMBER/S
!& `3 1W ✓R6,1V �STA7ES 6 rN IWO d y�y�fz-I 11�
2.
OWNER PHONE
3. JoNi✓&e,e- 9zy-Oz27
PERMIT NUMBER
805=-34
02* *5600
*5600 n
*56006
A *000
ADDRESS
CERTIFICATE
of EXEMPTION
ZIP
Actual Set Backs in Feet
2 3 4: 6 z
�• �s9/164-1 %�%•Q GST
FEES COLLECTED
9ZOC
North South —"'
East West �-i
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included %2
CONTRACTOR
PHONE
Size of Parcel
Zone Classification
140 - 2 1 -80
W,*4 fz Eiv -
Qzd -.4/71d
>RR. 70 y /B
-siti Fi"/G Yr
o 6479
4. ADDRESS
Plan Check
ZIP
Type Const.
Occupancy
Sprinklered
PtMrMt y�
�9ij;;W.rt lNwdoe /ti 4w7 rf vrt.
Fire Marshall ![
Mobile Home
moo. �+a /�O.�iJ'roserryc �w.B
Co. Engineer
Other (Specify)
Utilities
/J /v. /lC�i/,ciY Zr-I�-3 Yes ❑No ❑ Req'd.
DESIGNER PHONE luation Building Area in Sq. Ft. 0 2 * * 6 0 0
(v (- 0.0 3.74
5' ADDRESSZIP Main Floor U ~
pper Floors Garage Area Storage * 6 G (j-
:n
{-- 341. 1
CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
6. 770 UAACo2p
11=07-80
/ No. Baths No. Stories No. Rooms No. of Dwellings
TYPE ❑ NEW ElALT. LrJ AD'N. 1:1RPL. ❑ MVE. / r-
7
4 (�
7 OF ElOTHER
WORK FBLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑ POOL
CERTIFICATE
of EXEMPTION
Req'd.
I Recd. Not Req'd.
DESCRIBE WORK Enum. Dist. Location (Area)
8.4D,0i Ti SES/+DE✓yG� ( dz�
FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
UTILITIES ;j'#0l17Y'e Public El Private 2f
I I I
Single $ 4 1/7
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included %2
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume Building
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
Plumbing
%�
DATE OF APPLICATION 0/ U ®
( SIGNATURE OF APPLICAN V
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: GJcgrt�, o
NAME DATE 'P
Plan Check
Env. Heal h
/ Cif LL flF�Ent z' 3o
SEPA
PtMrMt y�
�9ij;;W.rt lNwdoe /ti 4w7 rf vrt.
Fire Marshall ![
Mobile Home
moo. �+a /�O.�iJ'roserryc �w.B
Co. Engineer
Other (Specify)
Utilities
TOTAL $
Pla s Examiner
\S7t.►�l
WHEN MACHINE VALIDATED IN THIS SPACE,
SEPA CYCckgrist F
THIS BECOMES A PERMIT.
t• `,' r
F '
B ing I hnician d�: ' PERMIT IS NONTRANSFERABLE ,1,'l, a�u e.� a 0; 3,4.1.:2 2;' 'i6 �;� 0'a
l PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSUED PERMIT NO. TOTAL
4.
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